Euthanasia: Emotional and costly
According to Dr. Marsha L. Heinke, a DVM Newsmagazine contributor and president of Marsha L. Heinke, CPA Inc., euthanasia is a core emotional and financial issue for practices.
Every veterinarian comes into his or her practice with preconceived notions about euthanasia, and how much clients are willing to spend on animals before they stop treatment. In the latest DVM Newsmagazine survey (page 1), the average stop-treatment point, according to veterinarians, is $976.
And that statistic just reflects sick animal treatment. Behavior problems remain a leading cause of relinquishment to shelters, humane societies and veterinary practices. Nationally, estimates from shelters reflect a downward trend in the total number of euthanasias overall, but estimates are that 5 million animals are killed each year, reports Dr. Gary Patronek, director of the Center for Animals and Public Policy at Tufts University.
But to quantify the loss to practice income is yet another story and it's like getting your arms around a cloud, Heinke explains.
First and foremost, most veterinary practices accounting systems aren't sophisticated enough to track euthanasias. Furthermore, many statistics are based on total deceased animals. Economically, euthanasia brings up many, many issues including staff turnover, stress, increased anxiety because of client pressure, "not to mention the lost stream of income from an animal that may have been prematurely euthanized due to a problem that could have been prevented."
A few years ago, Heinke and Dr. Suzanne Hetts, a veterinary behaviorist in Littleton, Colo., tried to quantify the cost of relinquishment to the veterinary practice for the American Animal Hospital Association. Heinke says they found it to be a daunting task, and much of the information is really generated from professional experience due to a lack of quality data in the for-profit sector to study death rates and specifically, euthanasia rates.
Consider these IDEXX VetConnect System 2002 statistics for age demographics with staffs of four or more doctors per practice:
Age breakdown for dogs:
* No age specified: 12.34 percent
* Under 1 year of age: 4.64 percent
* 1 year age: 7.5 percent
* 2-5 years old: 33.73
* 6-10 years old: 27.97 percent
* Over 10 years of age: 29.79 percent.
Age breakdown for cats:
* No age specified: 18.19 percent
* Under 1 year: 4.16 percent
* 1 year: 6.66 percent
* 2-5 years old: 29.13 percent
* 6-10 years old: 24.12 percent
* Over 10 years old: 30.76 percent.
Traditionally, the client turnover rate in veterinary practice averages 30 percent for many reasons, Heinke says.
From this lost client base, about 30 percent can typically be attributed to pet death loss. In other words, in a typical small animal practice 10 percent of a patient base can die off in a given year. If a mortality rate goes above 15 percent, you have to ask why, she adds.
But Heinke cautions that most practice data management is not adequately competent to drill down to find out how much of the mortality rate can be directly attributed to euthanasia, old age, trauma accidents, etc.
Heinke says that Dr. Gary Landsberg, veterinary behaviorist, has reported that veterinarians can lose 15 percent of canine and feline client base annually simply due to behavior problems. The practice may not euthanize these animals, but it could result in relinquishment to shelters.
Consider this: the average 2002 IDEXX VetConnect Systems data indicate the average sales per client is $410. The average spent per year, per dog is about $300, and $195 per cat. If 10 percent is an accurate assessment of euthanasia related deaths, then out of a patient base of 5,000 it represents a $137,500 loss to the practice.
If a portion of those animals are lost due to premature euthanasia, the economic impact is compounded year after year.
While the readily available statistics are poor on euthanasia, the point is this: Premature euthanasia has an economic impact on practice.
"If 10 dogs are euthanized each year prematurely because of a missed diagnostic test or even mild behavior problem, it still represents $3,000 a year, compounded with its life expectancy," Heinke explains.
"There is a psychology about being a veterinarian. You would think that all veterinarians have this altruistic belief that pet welfare is everything. But veterinarians do place a mental cap on the value of the animal. If appropriate care is going to cost a client more than $1,000, some veterinarians wonder if it is really worth it. And that preconceived value can be as low as $500. Well, if that veterinarian has that mindset, then he or she may not offer many options to the client. You may hear, 'There isn't much we can do. The quality of life is poor; you should consider euthanasia.' The reality is you are killing off your patient base."
Heinke says that veterinarians need to look for trends when tracking euthanasias. "If you see practice mortuary costs increasing as a percentage of revenue, or euthanasia numbers increasing as a percentage of the total pets seen for the year, or the percentage of returning clients dropping, they are all factors indicative of poor practice health."